Perspective on Etiology and Treatment of Bipolar Disorders in China: Clinical Implications and Future Directions

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Fig. 1


  1. 1.

    Vieta E, Berk M, Schulze TG, Carvalho AF, Suppes T, Calabrese JR, et al. Bipolar disorders. Nat Rev Dis Primers 2018, 4: 18008.

    Article  PubMed  Google Scholar 

  2. 2.

    Lu YA, Lee SY, Chen SL, Chen SH, Chu CH, Tzeng NS, et al. Gene-temperament interactions might distinguish between bipolar I and bipolar II disorders: a cross-sectional survey of Han Chinese in Taiwan. J Clin Psychiatry 2012, 73: 339–345.

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Wang TY, Lee SY, Chen SL, Chang YH, Chen SH, Huang SY, et al. Gender-specific association of the SLC6A4 and DRD2 gene variants in bipolar disorder. Int J Neuropsychopharmacol 2014, 17: 211–222.

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Hu MC, Lee SY, Wang TY, Chang YH, Chen SL, Chen SH, et al. Interaction of DRD2TaqI, COMT, and ALDH2 genes associated with bipolar II disorder comorbid with anxiety disorders in Han Chinese in Taiwan. Metab Brain Dis 2015, 30: 755–765.

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Chung YE, Chen SC, Chuang LC, Shih WL, Chiu YH, Lu ML, et al. Evaluation of the interaction between genetic variants of GAD1 and miRNA in bipolar disorders. J Affect Disord 2017, 223: 1–7.

    Article  CAS  PubMed  Google Scholar 

  6. 6.

    Li M, Chang H, Xiao X. BDNF Val66Met polymorphism and bipolar disorder in European populations: A risk association in case-control, family-based and GWAS studies. Neurosci Biobehav Rev 2016, 68: 218–233.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Wang Z, Li Z, Chen J, Huang J, Yuan C, Hong W, et al. Association of BDNF gene polymorphism with bipolar disorders in Han Chinese population. Genes Brain Behav 2012, 11: 524–528.

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Wang Z, Fan J, Gao K, Li Z, Yi Z, Wang L, et al. Neurotrophic tyrosine kinase receptor type 2 (NTRK2) gene associated with treatment response to mood stabilizers in patients with bipolar I disorder. J Mol Neurosci 2013, 50: 305–310.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Jan WC, Yang SY, Chuang LC, Lu RB, Lu MK, Sun HS, et al. Exploring the associations between genetic variants in genes encoding for subunits of calcium channel and subtypes of bipolar disorder. J Affect Disord 2014, 157: 80–86.

    Article  CAS  PubMed  Google Scholar 

  10. 10.

    Li M, Luo XJ, Rietschel M, Lewis CM, Mattheisen M, Müller-Myhsok B, et al. Allelic differences between Europeans and Chinese for CREB1 SNPs and their implications in gene expression regulation, hippocampal structure and function, and bipolar disorder susceptibility. Mol Psychiatry 2014, 19: 452–461.

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Wen Z, Chen J, Khan RA, Wang M, Song Z, Li Z, et al. Polymorphisms in NRGN are associated with schizophrenia, major depressive disorder and bipolar disorder in the Han Chinese population. J Affect Disord 2016, 194: 180–187.

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Lai YC, Kao CF, Lu ML, Chen HC, Chen PY, Chen CH, et al. Investigation of associations between NR1D1, RORA and RORB genes and bipolar disorder. PLoS One 2015, 10: e0121245.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. 13.

    Li Z, Zhang C, Fan J, Yuan C, Huang J, Chen J, et al. Brain-derived neurotrophic factor levels and bipolar disorder in patients in their first depressive episode: 3-year prospective longitudinal study. Br J Psychiatry 2014, 205: 29–35.

    Article  PubMed  Google Scholar 

  14. 14.

    Zhao G, Zhang C, Chen J, Su Y, Zhou R, Wang F, et al. Ratio of mBDNF to proBDNF for Differential Diagnosis of Major Depressive Disorder and Bipolar Depression. Mol Neurobiol 2017, 54: 5573–5582.

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Fung G, Deng Y, Zhao Q, Li Z, Qu M, Li K, et al. Distinguishing bipolar and major depressive disorders by brain structural morphometry: a pilot study. BMC Psychiatry 2015, 15: 298.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Yang H, Li L, Peng H, Liu T, Young AH, Angst J, et al. Alterations in regional homogeneity of resting-state brain activity in patients with major depressive disorder screening positive on the 32-item hypomania checklist (HCL-32). J Affect Disord 2016, 203: 69–76.

    Article  PubMed  Google Scholar 

  17. 17.

    Wang Z, Chen J, Yang H, Ma Y, Meron D, Liu T, et al. Assessment and management of bipolar disorder: Principal summary of updated Chinese guidelines. Bipolar Disord 2018, 20: 289–292.

    Article  PubMed  Google Scholar 

  18. 18.

    Wang Z, Chen J, Zhang C, Gao K, Hong W, Xing M, et al. Guidelines concordance of maintenance treatment in euthymic patients with bipolar disorder: Data from the national bipolar mania pathway survey (BIPAS) in mainland China. J Affect Disord 2015, 182: 101–105.

    Article  PubMed  Google Scholar 

  19. 19.

    Wang G, Cheng Y, Wang JN, Wu SH, Xue HB. Efficacy and safety of olanzapine for treatment of patients with bipolar depression: Chinese subpopulation analysis of a double-blind, randomized, placebo-controlled study. Neuropsychiatr Dis Treat 2016, 12: 2077–2087.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Li H, Gu N, Zhang H, Wang G, Tan Q, Yang F, et al. Efficacy and safety of quetiapine extended release monotherapy in bipolar depression: a multi-center, randomized, double-blind, placebo-controlled trial. Psychopharmacology (Berl) 2016, 233: 1289–1297.

    Article  CAS  Google Scholar 

  21. 21.

    Li K, Shen S, Ji YT, Li XY, Zhang LS, Wang XD. Melatonin augments the effects of fluoxetine on depression-Like behavior and hippocampal BDNF-TrkB signaling. Neurosci Bull 2018, 34: 303–311.

    Article  CAS  PubMed  Google Scholar 

  22. 22.

    Liang S, Vega R, Kong X, Deng W, Wang Q, Ma X, et al. Neurocognitive graphs of first-episode schizophrenia and major depression based on cognitive features. Neurosci Bull 2018, 34: 312–320.

    Article  PubMed  Google Scholar 

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This insight article was supported by the National Key Research and Development Program of China (2016YFC1307100 and 2016YFC1307105), the Shanghai Key Medicine Specialties Program (ZK2015A06), Projects of International Cooperation and Exchanges National Natural Science Foundation of China (81761128032), and the Sanming Project of Medicine in Shenzhen, China (SZSM201612006).

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Correspondence to Yiru Fang.

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Wang, Z., Jun, C., Gao, K. et al. Perspective on Etiology and Treatment of Bipolar Disorders in China: Clinical Implications and Future Directions. Neurosci. Bull. 35, 608–612 (2019).

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